Title Page
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Control ID Number:
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Control Title:
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Site:
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Conducted on:
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Prepared by:
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Location:
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Personnel
MHF Risk Control Measures (CM) Information
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MHF Control ID:
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Control Title:
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Control Description:
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Is the control description correct/ accurate? Please enter the new description if found any discrepancies?
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New Proposed Control Title & Description:
Control Category
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Please select control type category?
- Alarm
- Contractor Management
- Emergency Management
- Interlock/ Trip
- Maintenance Inspection
- Management of Change
- Non Return Valve
- Operator Inspection
- Procedure (SOP)
- Release Containment
- Relief Valve
- Signage
- Training
- Ventilation
- Work Permit System
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Is the control category listed above?
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For other, please specify the control type/ category:
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Enter the Performance Standard Criteria:
For Alarm
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Is the control type/ category correct? Otherwise, please select N/A
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Is the control fully implemented:
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Does the alarm exist? Has the alarms or the associated equipment been isolated or bypassed?
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Does a maintenance schedule exist for the alarm, including function test?
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Is the maintenance schedule for the alarm considered appropriate? E.g. The maintenance schedule meets the requirements established in the RCM or it is otherwise assessed appropriate<br><br>
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Enter PM reference number in Maximo:
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Is the control fully functional?
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Is the alarm maintained in accordance to the schedule? Has all relevant information been obtained for completion of the job (eg. Data sheets/ meters) <br><br>
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Have all maintenance reports received? Any follow-up activities required have been raised/ completed such as subsequent work orders?
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What is the history of failure/ incidents? Are calibration results within the critical operating parameter limits?
For Trip/ Interlock
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Is the control type/ category correct? Otherwise, please select N/A
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Is the control fully implemented:
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Does the trip exist? What asset triggers the trip and what asset does it trip?
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Has the trip and associated equipment been isolated or bypassed?
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Does a maintenance schedule exist for the trip, including function test?
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Enter PM reference number in Maximo:
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Is the maintenance schedule for the trip considered appropriate? E.g. The maintenance schedule meets the requirements established in the RCM or it is otherwise assessed appropriate<br><br>
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Is the control fully functional?
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Is the trip maintained in accordance to the schedule? Has all relevant information been obtained for completion of the job (eg. Data sheets/ meters) <br><br>
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Have all maintenance reports received? Any follow-up activities required have been raised/ completed such as subsequent work orders?
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What is the history of failure/ incidents? Are calibration results within the critical operating parameter limits?
For Operator Inspection
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Is the control type/ category correct? Otherwise, please select N/A
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Is the control fully implemented:
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Does the operator inspection exist?
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How is the requirement for operator inspection documented?
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Are the requirements considered clear and appropriate?
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Enter the SOP and Clause reference numbers:
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Is the control fully functional?
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Is there a record of the Operator having undertaken an inspection as described?
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Take a photo of the last completion record sheet for evidence:
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Any follow-up activities are completed as required? (E.g. Corrective work orders raised?)
For Procedure (Standard Operating Procedure)
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Is the control type/ category correct? Otherwise, please select N/A
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Is the control fully implemented:
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Does the procedure exist? Is it located in the controlled document library in Inflo?
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Enter the SOP and Clause reference numbers:
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Does the procedure have adequate review frequency and management sign-off (review information located in the categories tab in Inflo)?
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Is the procedure current (e.g. No outstanding review/ work flows)?
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When the procedure was last reviewed?
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Is the procedure accurate and does it contain sufficient detail?
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Is the control fully functional?
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Have site personnel been adequately trained or been provided on-the-job familiarisation for the procedure?
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Is there any substantive evidence of the procedure not being followed or being breached?
For Maintenance Inspection
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Is the control type/ category correct? Otherwise, please select N/A
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Is the control fully implemented:
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Is the control tagged as an MHF Asset in Maximo?
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Enter Maximo Location ID Number:
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Enter Asset ID number in Maximo:
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Does a maintenance schedule exist for the asset?
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Enter PM reference number in Maximo:
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Is the maintenance inspection (PM frequency and Job Plan detail) for the asset considered appropriate? <br><br>(E.g. The maintenance schedule meets the requirements established in the RCM or is otherwise assessed as appropriate)
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Is the control fully functional?
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Is the asset maintained in accordance to the schedule? Has all relevant information been obtained for completion of the job (eg. Data sheets/ meters) <br><br>
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Have all maintenance reports received? Any follow-up activities required have been raised/ completed such as subsequent work orders?
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What is the history of failure/ incidents?
Raised Actions/ Recommendations
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Please contact your area MHF Coordinator and discuss the actions/ tasks to be completed with the actioners
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All actions are to be entered into MHF Action Register database and please contact MHF Coordinator for individual unique reference number for monitoring/ tracking its completion progress.
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Action 1:
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Action 2:
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Action 3:
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Action 4:
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Action 5:
Control Review Ratings/ Audit Findings
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Audit Findings:
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Enter Control Rating (0-6 Scale):
- Rated 0 - Risk Control Measure does not exist (at all) as described in the Safety Case
- Rated 1 - Key components of the Risk Control Measure to prevent/ mitigate the major incident hazard from occurring are missing
- Rated 2 - Parts of the Risk Control Measure to prevent/ mitigate the major incident hazard are not implemented and parts of the control are not maintained
- Rated 3 - Risk Control Measure exists but is not preventing or mitigating the major incident hazard
- Rated 4 - Risk Control Measure exists as required but is not effective at preventing/ mitigating the major incident hazard or not being properly performance monitored
- Rated 5 - Risk Control Measure exists, is effective and is performance monitored but does not meet its performance standard
- Rated 6 - Risk Control Measure fully implemented and fully functional
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Please contact your site MHF Coordinator if you determined poor control performance with rating 0, 1, 2 or 3 at the end of the review.
Other comments
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Please enter other comments (if any):
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Other supporting evidence/ photos:
Signature
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Please sign here: